The hospital illusion: on the “thoughts” of Patrick Kennedy

I have been listening and made it through the first hour of the Murphy Hearing and think I will try again later.  Lots to think about… Lots to talk about.

My first impression was that someone has talked to Tim Murphy and told him not to talk so much.  I think the effort was for him to appear kinder and more distinguished. I don’t know about that but quieter was nice.

My major impression though was of Patrick Kennedy.  He was treated as royalty and the anticipatory joy at the next word he might say was so thick you could cut it with a knife.   He hit so many softballs I felt sure he would soon tell them to throw something over hand but he never did.

And in the short time I watched he did more damage than anyone else.  If he does not own stock in a psychiatric hospital someone should give him some.   He way past earned it.

His argument was simple.

1. Mental illness is a brain disorder.   Period… Period.. Period.
2. It is not ethical,  moral and certainly not medically  appropriate to  treat it in any way different than any other medical condition.
3.  When people get really sick they go to the hospital to get the level of care they need and people
with mental illness need to have the same access to medical care that they need and be able to get hospital care.
4.  It is a moral travesty and the rankest form of discrimination that they may not have that access.

There are about a million things wrong with his logic but because of his assumed status as expert on all things mental health his views have real consequences.   They feed into all the heavy breathing about back to the asylum and other such nonsense and serve as apology and justification for people who want to cloak their hurtful, traumatizing and discriminatory ideas and practices in the prettiest ethical clothes they can.   He makes Murphy easier and more palatable.   That is his real danger.

My immediate response to what he had to say was simple.   Psychiatric hospitals are hospitals in name only.   They aren’t really hospitals even if doctors and nurses work there.

Listening to that I think about the lady I know who has been hospitalized 25 times…. in the same hospital.   She was not psychotic and her major presenting symptom was good insurance. She liked her psychiatrist and her psychiatrist taught her that when she felt bad she was getting ready to fall apart. She felt bad a lot. She would be in the hospital 5-7 days max for stabilization and would normally return about every 4-6 months. No one in the hospital thought they were helping her. “Frequent flyer” was the kindest thing they called her. She was admitted not because they thought they would help. She was admitted because they thought they would be paid for her admission.

In this age of evidence based treatment I know of absolutely no data that would lead to anyone concluding that psychiatric hospitalization is anything close to an evidence based practice. There seems little evidence if any that life is better. The only thing admissions predict is that you are likely to be admitted again.

In a hospital everyone is treated differently based on what is wrong. In a psychiatric hospitals everyone is treated the same regardless of what is wrong.

Even people who work in psych hospitals understand the most important thing is not what happens in the hospital but what happens when you leave.

In most states the role of psych hospitals is to stabilize crisis situations and not really to treat anything.

Psychiatric hospitals frequently traumatize their patients. In some hospitals it is frequent and almost inevitable. No medical hospital could survive like that.

In medical hospitals people leave when their complaints are dealt with. In psych hospitals they leave when the insurance pulls the plug.

Services offered in a medical hospital normally can’t be received elsewhere. Services in psychiatric hospitals normally can.

Medication given in a medical hospital is normally effective while the patient is in the hospital. Medication in a psych hospitals normally does not work until weeks after discharge.

People are admitted to medical hospitals voluntarily.

The ship on psychiatric hospitalization has long ago sailed. They are ineffective and cost way too much to serve far too few. They are largely warehouses with cookie cutter programming. The experience of most people hospitalized is coping with chronic boredom and arbitrary authority. It is not a confirmation of their human worth and ability to find their way to a better life but an attack on their dignity and potential as a human being.

I know that Kennedys sermon is irrelevant to Tennessee. The effort in Tennessee is to give people options to hospitalization and if they are hospitalized to make sure they are less likely to be hospitalized again. I have talked about some of those efforts in other posts.

Kennedy is wrong. He ignores the traumas and real injuries in the lives of so many and tells us to blame the brain. At a time when we should be fighting for our rights for more he would crusade for the right for less.

With Kennedy speaking I understand why Murphy was so quiet.


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